Healthcare Provider Details

I. General information

NPI: 1346175940
Provider Name (Legal Business Name): ALISON JANE KLOSTERMANN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 E DIVISION ST
FOND DU LAC WI
54935-4560
US

IV. Provider business mailing address

7375 RUSTIC RD
WEST BEND WI
53090-8618
US

V. Phone/Fax

Practice location:
  • Phone: 920-923-7940
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17799-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: